G. J.
PATEL INSTITUTE OF AYURVEDIC STUDIES AND
RESEARCH
&
S. G. PATEL AYURVEDA HOSPITAL AND MATERNITY HOME
(A Constituent College of The CVM University),
New Vallabh Vidyanagar, Anand, Gujarat – 388120.
A Compilation work
On
VARICOSE VEIN
Prepared By- MIRAL J. HIRPARA
I.D. Number:1557 4th PROFESSIONAL B.A.M.S.
DEPARTMENT OF SHALYA TANTRA
YEAR 2024-2025
1
G. J. PATEL INSTITUTE OF AYURVEDIC STUDIES AND
RESEARCH
&
S. G. PATEL AYURVEDA HOSPITAL AND MATERNITY HOME
(A Constituent College of The CVM University),
New Vallabh Vidyanagar, Anand, Gujarat – 388120.
CERTIFICATE
This is to certify that [Link] J. Hirpara of 4th year
Professional B.A.M.S. student, I.D. No - 1557 Examination No.
….………….. has satisfactorily completed her compilation work on
VARICOSE VEIN in the term ending in year 2024-2025 of
Department of Shalya Tantra as a part of partial fulfilment of the
prescribed curriculum.
Faculty in charge: Head of Department:
Dep. of Shalya Tantra Dep. of Shalya Tantra
Date:
Place: New V.V. Nagar
2
ACKNOWLEDGEMENT
Compilation marks a milestone in graduate studies. As such a March occasion, it is with deep sense of
gratitude that I recollect and acknowledge the help received from multitude of score. Though to name
all in a short acknowledgement is next to impossible
I take this opportunity to express my profound sense of gratefulness to the chairmen and the management
committee of THE CVM UNIVERSITY for providing me the opportunity to do studies
I take this opportunity to thank Director Sir Dr. C. H. Babaria for providing all necessary facilities for
this compilation work. With a heart full of gratitude, I acknowledge HOD & Professor Dr. DIPSINH
CHAVDA, Dep. Of SHALYA TANTRA for his paternal affection and unstinted cooperation ever
remain a beckon of hope in all my future endeavours. It will be my cherished goal to attain the exacting
standards of sincerity and hard work the yard stick which my guide and mentor measured life
My special thanks to professor Dr. SANJAY TRIVEDI, Dept of Shalya tantra for his valuable
guidance, inspiration and all teaching staff without whose guidance and cooperation this work would
no blossomed.
My most grateful thanks to Associate professor Dr. DHIMANT BHATT, Dept. of Shalya tantra for
his constructive criticism during this course and preparation of this compilation.
My most grateful thanks to Assistant professor Dr. SNEHAL PATIL, Dr. SNEHAL SONANI & Dr.
SONAL PANCHAL Dept. of Shalya tantra for her constructive criticism during this course and
preparation of this compilation.
I cannot forget to thank Acharyas and Authors, whose literature I have consulted, which help me
ultimately in completion of this dissertation. I am also thankful to my seniors and juniors for their
guidance and support.
A life without friend id no life. It is to those friends and colleagues who at the momentof desolation
brought in an ounce of sunshine, laughter and so kindly share their wealth of knowledge that I ever
remain grateful. Words remain short to say thanks to my family for giving support throughout my
work.
I am thankful for the library staff of our Ayurveda College for their cooperation in providing library
facilities
Last but not the least, I express my thanks to all person who have helped me directly or indirectly with
apologies for not being able to identify them individually.
MISS. MIRAL HIRPARA
4TH PROFESSIONAL B.A.M.S.
3
INDEX
[Link]. Topic Name Page no.
1.
Definition and Prevalence 5
2.
Introduction 6
3.
Venous system of lower limb 7
4.
Factors helping in venous return 8
5.
Difference between varicose veins and spider veins 9
6.
Predisposing factors 10
7.
Symptoms 11
8.
Pathogenesis 12
9.
Stages 13
10.
Diagnostic test 14
11.
Management 15
12.
Side effect of management 19
13.
Preventive measures 20
14.
Complications 21
15.
Recurrence rate 23
4
16.
Research abstract 24
17.
Bbiiliography 25
Definition:
➢ Varicose veins, or varicosities, are swollen, twisted veins that lie just under the skin.
They usually occur in the [Link] varicose veins form in other parts of the
body e.g oesophagus, testicles.
• Prevelance:
➢ Varicose veins are very common.
➢ Around 1/3 of all adults have varicose veins.
➢ They are more common in people assigned female at birth than in people assigned male
at birth.
5
• Introduction:
➢ They can be painful or itchy.
➢ Spider veins, which may surround varicose veins, are smaller red or purple lines that
appear close to your skin’s surface.
➢ Although they can be unsightly and uncomfortable, varicose veins aren’t dangerous for
most people.
➢ In some cases, severe varicose veins can lead to serious health problems, such as blood
clots.
● Venous System of lower limb consists of:
➢ Deep system of veins which lies below the deep fascia.
➢ Superficial system of veins which lies outside the deep fascia (carry 10% blood)
Perforating veins which pass through the deep fascia joining the superficial to the
deep system of veins.
6
Factors Helping in Venous return:
➢ Negative pressure in thorax during inspiration to -6 mm.
➢ Calf muscle pump: Normal venous pressure in relaxed state 20mm of Hg. Rises to 80100
mm of Hg during muscle contraction.
➢ Vis a tergo: arterial pressure transmitted to venous side through capillary bed
➢ Competent valves
➢ Venae commitants: lie by the side of artery, helped by arterial pulsation to propel blood.
7
● Difference between varicose vein and spider veins:
➢ Varicose veins and spider veins are both types of venous disease, but they look different.
➢ Spider veins are smaller and thinner than varicose veins.
➢ They look like red or blue spider webs or branches of a tree, and they are close to the
skin’s surface.
➢ Spider veins aren’t usually painful.
➢ They can appear anywhere on your body, most often behind your knee, on your feet or
on your face.
➢ Varicose veins usually appear on your feet and legs.
8
• Predisposing factor's :
➢ Age: Because of the aging process, vein walls and valves don’t work as well as they once
did. Veins lose elasticity and stiffen.
➢ Gender: Female hormones can allow the walls of the veins to stretch. People who are
pregnant, taking the birth control pill or going through menopause have a higher risk of
varicose veins because of changes in hormone levels.
➢ Family history: This condition can be inherited (runs in families).
➢ Lifestyle: Standing or sitting for long periods decreases circulation. Wearing restrictive
clothing, such as girdles or pants with tight waistbands can decrease blood flow.
➢ Overall health: Certain health conditions, such as severe constipation or certain tumors,
increase pressure in the veins.
➢ Tobacco use: People who use tobacco products are more likely to develop varicose veins.
➢ Weight: Excess weight puts pressure on blood vessels.
9
• Symptoms:
➢ Bulging veins: Twisted, swollen, rope-like veins are often blue or purple. They appear
just below the surface of the skin on your legs, ankles and feet. They can develop in
clusters. Tiny red or blue lines (spider veins) may appear nearby.
➢ Heavy legs: Muscles in your legs may feel tired, heavy or sluggish, especially after
physical activity.
➢ Itching: The area around varicose veins may itch.
➢ Pain: Legs may be painful, achy or sore, especially behind your knees. You might have
muscle cramps.
➢ Swelling: Your legs, ankles and feet can swell and throb.
➢ Skin discolorations and ulcers: If left untreated, varicose veins can cause brown
discolorations on your skin. Severe varicose veins can cause venous ulcers (sores) on
your skin.
10
11
●
Pathogenesis:
➢ Varicose veins occur when the walls of your veins weaken.
➢ As blood pressure in your vein increases, the weakened walls allow your vein to get
bigger.
➢ As your vein stretches, the valves that keep blood moving in one direction in your
vein can’t work like they should.
➢ Sluggish blood backs up or pools in your vein, causing your vein to swell, bulge and
twist.
➢ Vein walls and valves can become weak for several reasons, including: Hormones.
The aging process.
Excess weight.
Restrictive clothing.
Pressure inside the vein from standing for long periods.
Stages:
12
●
Diagnostic test :
➢ Varicose veins are close to the surface of your skin and easy to see.
➢ Healthcare providers can diagnose the condition during a physical examination.
13
●
They’ll feel your veins and examine them while you’re sitting and standing.
➢ To see detailed images of your veins and check for complications, your provider
may recommend an ultrasound.
➢ This safe, painless test uses sound waves to produce pictures of tissues inside your
body.
➢ Ultrasounds can show blood clots and how your valves are working.
Management:
➢ Elevation: To increase blood flow and decrease pressure in your veins, you should
elevate your legs above your waist several times throughout the day.
14
●
➢ Elastic stockings: Supportive stockings or socks compress your veins and reduce
discomfort. The compression stops your veins from stretching and helps blood flow.
15
➢ Injection therapy (sclerotherapy): During sclerotherapy, a healthcare provider injects a
solution into your vein. The solution causes the vein walls to stick together. Eventually,
your vein turns into scar tissue and fades away.
➢ Laser therapy: In a minimally invasive procedure called endovenous thermal ablation,
healthcare providers use a catheter (a long, thin tube) and laser to close off a damaged
vein
16
➢ Vein surgery: During these procedures, also called ligation and stripping, the surgeon
ties off your affected vein (ligation) to stop blood from pooling. The surgeon may
remove (strip) the vein to prevent varicose veins from reappearing.
➢ endothermal ablation – where heat is used to seal affected veins.
➢ ligation and stripping – the affected veins are surgically removed.
17
➢ Half of the people who have surgical stripping get varicose veins again within five years,
and varicose veins can happen again after endovenous ablation as well.
● Side effects of treatments:
Scarring. Skin burns.
Infection.
Injury to a nerve.
18
Deep vein thrombosis (a blood clot in a vein deep inside your body).
Sclerotherapy can cause side effects that
include:
Redness or bruising for a few days where a needle went into your skin.
Brown areas (for several months) on skin where the needle touched.
Lumps or hardness for a few months.
With sclerotherapy, new varicose veins can happen and need treatmen
t.
● Preventive measures:
➢ Avoid long periods of standing: To encourage blood flow, take regular breaks to stretch
and walk around, especially if you have a job that requires you to be on your feet.
➢ Elevate your legs: Raising your feet above your waist helps blood flow to your heart.
19
➢ Maintain a healthy weight: Getting rid of excess pounds reduces pressure inside your
blood vessels.
➢ Quit tobacco use: Smoking damages blood vessels, decreases blood flow and causes a
wide range of health problems.
➢ Stay active: To improve circulation, move frequently and avoid sitting still for
prolonged periods.
➢ Try compression stockings: Support socks and pantyhose compress your veins and help
blood circulate, which can prevent varicose veins from getting worse. Wear clothes that
fit properly: To encourage blood flow, make sure your waistband isn’t too tight.
● Complications:
➢ Varicose veins can cause ulcers (open sores), bleeding and skin discoloration if left
untreated.
➢ Severe varicose veins may be a sign of chronic venous insufficiency.
➢ This condition affects your veins’ ability to pump blood to your heart.
➢ People who have varicose veins may be more likely to develop blood clots.
20
➢ It’s important to tell your healthcare provider about varicose veins.
➢ Your provider should evaluate and monitor you for clotting disorders such as:
➢ Superficial thrombophlebitis: Blood clots can form inside varicose veins, causing a
condition called superficial venous thrombosis or superficial thrombophlebitis.
Thrombophlebitis is painful but isn’t usually dangerous. It’s also treatable.
➢ Deep vein thrombosis (DVT): People with varicose veins have a higher risk of deep
vein thrombosis, a blood clot in a vein deep inside your body.
21
.
➢ Pulmonary embolism: A blood clot in your body (usually resulting from DVT) can
become lodged in your lung. Pulmonary embolism is a life-threatening condition that
requires immediate treatment.
● Recurrence rate:
➢ Although treatments are effective, varicose veins can return.
➢ They’re more likely to come back in people who become pregnant after treatment.
➢ You have a higher chance of varicose veins reappearing if you have obesity or have a
sedentary lifestyle.
22
Research abstract
Varicose veins are a common vascular condition known for causing discomfort
and cosmetic concerns. This comprehensive narrative review delves into their anatomy,
pathophysiology, and modern treatment options, with a focus on endovenous
techniques and sclerotherapy. The review starts by emphasizing the intricate anatomy
of lower extremity venous circulation, underlining the significance of both superficial
and deep venous networks in venous return. It also addresses how changes in the venous
wall, including valvular insufficiency, contribute to the development of varicose veins.
Endovenous techniques like endovenous laser ablation (EVLA), radiofrequency
ablation (RFA), and mechanochemical endovenous ablation (MOCA) are explored in
detail. These minimally invasive procedures have revolutionized varicose vein
treatment, offering high success rates and quicker recovery compared to traditional
surgery. The review also highlights their efficacy and safety profiles, aiding clinicians
in informed decision-making. Sclerotherapy, a vital modality for varicose veins, is
thoroughly examined, covering both liquid and foam sclerotherapy. Foam
sclerotherapy, in particular, is recognized for its improved outcomes. The review
provides a comprehensive comparison of these treatment modalities, highlighting
differences in technical success, recurrence rates, and costeffectiveness. Patient
preferences and satisfaction play a significant role in choosing the right treatment.
Safety and potential complications associated with these treatments are explored, with
23
a focus on minor issues and rare adverse events. This review also emphasizes the
positive impact of varicose vein interventions on patients' quality of life.
Bibilography
1. A Concise Textbook of Surgery by Somen Das; 6th edition, reprint in July, 2010;
Published by Dr. S. Das.
2. SRB’s Manual of Surgery by Sriram Bhat M; 6th edition, reprint in 2019; Published by
Jaypee Brothers Medical Publishers.
24